STU244E Chapter12.pdf

5/2/24 Because learning changes every...

5/2/24 Because learning changes everything.® Abnormal Psychology 9th Edition Susan Nolen-Hoeksema Yale University © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Chapter 12: Eating Disorders © McGraw Hill LLC 2 1  5/2/24 Chapter Outline Characteristics of Eating Disorders. Understanding Eating Disorders. Treatments for Eating Disorders. © McGraw Hill LLC 3 Anorexia Nervosa People starve themselves for very long periods of time and remain convinced that they need to lose more weight. Amenorrhea: Women and girls who have begun menstruating stop having menstrual periods. Restricting type of anorexia nervosa: Refusing to eat and/or engaging in excessive exercise as a way of preventing weight gain. Binge/purge type of anorexia nervosa: People engage in binge eating or purging behaviors. Dangerous consequences include cardiovascular complications, stomach expansion, weak bones, kidney damage, impaired immune system, and suicide. © McGraw Hill LLC 4 2  5/2/24 Bulimia Nervosa Bingeing followed by behaviors designed to prevent weight gain from the binges. Bingeing: Uncontrolled eating of large amounts of food. Behaviors to prevent weight gain. Self-induced vomiting. Abuse of laxatives, diuretics, or other purging medications. Fasting. Excessive exercise. Dangerous complications include electrolyte imbalance leading to heart failure, suicide. © McGraw Hill LLC 5 Binge-Eating Disorder Recurrent episodes of binge eating without compensatory behavior and accompanied by: Eating more rapidly than normal. Eating until feeling uncomfortably full. Eating large amounts when not physically hungry. Eating alone because of embarrassment. Feeling disgusted with oneself, experiencing depression, or feeling very guilty after a binge. Often leads to obesity. Depression is common. © McGraw Hill LLC 6 3  5/2/24 Table 2 Comparison of Eating Disorders Table 2 Comparison of Eating Disorders The eating disorders vary on several characteristics. Characteristic Anorexia Anorexia Nervosa Bulimia Nervosa Binge-eating Disorder Nervosa Binge/Purge Type Restricting Type Body weight Significantly Significantly Often normal weight Often significantly underweight underweight or overweight overweight Body image Severely Severely disturbed Overconcerned with Often very distressed disturbed weight and shape with overweight Bingeing No Yes Yes Yes Purging or other No Yes Yes No compensatory behaviors Sense of lack of control No During binges Yes Yes over eating © McGraw Hill LLC 7 Other Specified Feeding or Eating Disorder Partial-syndrome eating disorders. Syndromes that don’t meet the full criteria for anorexia nervosa or bulimia nervosa. Atypical anorexia nervosa. All the criteria for anorexia nervosa are met but the individual’s weight is within or above the normal range. Bulimia nervosa of low frequency and/or limited duration. Meeting all of the criteria for bulimia nervosa, except that the binge eating and inappropriate compensatory behaviors occur less than once a week and/or for less than 3 months. Night eating syndrome. Regularly eating excessive amounts of food into the night after dinner. © McGraw Hill LLC 8 4  5/2/24 Obesity 1 Not in DSM-5-TR but associated with some mental disorders. Body mass index (BMI) of 30 or over. Calculated as weight in pounds multiplied by 703, then divided by the square of height in inches. Associated with an increased risk of: Coronary heart disease, hypertension, and stroke. Type 2 diabetes and cancer. Low quality of life and emotional problems. Cause. Living in a toxic food environment. Lack of exercise. © McGraw Hill LLC 9 Figure 1 Obesity in the United States. Source: https://www.cdc.gov/nchs/products/databriefs/db288.htm Access the text alternative for slide images. © McGraw Hill LLC Prevalence of Obesity Among Adults and Youth: United States, 2015–2016, NCHS Data Brief No. 288, October 2017, Centers for Disease Control and Prevention 10 5  5/2/24 Obesity 2 Popular ways to lose weight. Self-help books. Commercial weight-loss programs. Weight-loss drugs. Healthy ways to lose weight. Eat nutrient-dense foods and avoid foods with empty calories. Minimum of 30 min of physical activity daily. Structure environment so that healthy choices are easier to make. Be more active throughout the day. © McGraw Hill LLC 11 Understanding Eating Disorders: Biological Factors Genetic factors. Changes of puberty in girls. Imbalance or dysregulation of any of the neurochemicals. Lowered functioning of the hypothalamus. Abnormalities in the levels of several hormones important to its functioning. Abnormalities in the systems regulating the neurotransmitter serotonin. © McGraw Hill LLC 12 6  5/2/24 Understanding Eating Disorders: Sociocultural and Psychological Factors 1 Social pressures and cultural norms. Social media. Thin ideal promoted by media and body dissatisfaction. Athletes and eating disorders. Cognitive factors. Low self-esteem and wanting to please others. Dichotomous thinking style—“all-or-nothing” thinking. © McGraw Hill LLC 13 Understanding Eating Disorders: Sociocultural and Psychological Factors 2 Emotion regulation difficulties. Maladaptive strategies for dealing with painful emotions. Disordered eating patterns involving binge eating. Dieting subtype. Depressive subtype. Family dynamics. Difficulty with separation and individuation from one’s family. Family with eating disorder. Low parental warmth and high parental demands. © McGraw Hill LLC 14 7  5/2/24 Treatments for Eating Disorders: Psychotherapy for Anorexia Nervosa Cognitive-behavioral therapy. Client's overvaluation of thinness is confronted. Rewards are made contingent on the person's gaining weight. Family therapy. Person with anorexia and their family are treated as a unit. © McGraw Hill LLC 15 Treatments for Eating Disorders: Psychotherapy for Bulimia Nervosa and Binge-Eating Disorder Cognitive-behavioral therapy. Therapist teaches the client to monitor the cognitions that accompany eating. Interpersonal therapy. Client and therapist discuss interpersonal problems related to the eating disorder and develop strategies to solve these problems. Supportive-expressive psychodynamic therapy. Therapist encourages the client to talk about problems related to the eating disorder but in a highly nondirective manner. Behavioral therapy. Client is taught how to monitor food intake, introducing avoided foods into diet, coping techniques for avoiding bingeing. © McGraw Hill LLC 16 8  5/2/24 Treatments for Eating Disorders: Biological Therapies Selective serotonin reuptake inhibitors. Reduce binge-eating and purging behaviors. Fail to restore the individual to normal eating habits. Antidepressants. Used to treat anorexia nervosa and result in reduction of symptoms. Antipsychotics. Lead to increases in weight in people with anorexia nervosa. Antiepileptic medications and obesity medications. © McGraw Hill LLC 17 Figure 2 Multiple Pathways into the Eating Disorder. Access the text alternative for slide images. © McGraw Hill LLC 18 9  5/2/24 Because learning changes everything.® www.mheducation.com © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Figure 2 Multiple Pathways into the Eating Disorder - Text Alternative Return to parent-slide containing images. The flowchart shows social pressures toward extreme thinness leads to negative body image. Overvaluation of appearance, perfectionism, low self-esteem, et cetera leads to anxiety and depression, and excessive dieting. Genetic predisposition leads to both negative body image and anxiety and depression, and excessive dieting. Negative body image leads to excessive dieting. Anxiety and depression lead to excessive dieting and impulsive binge eating. Excessive dieting leads to impulsive binge eating, which further leads to compensatory behaviors (purging, excessive exercise), and finally leads to Bulimia nervosa. Impulsive binge eating leads back to anxiety and depression and binge-eating disorder. After excessive dieting, if successful in losing weight, reinforced by society and sense of control, it leads back to excessive dieting and further to Anorexia nervosa. Return to parent-slide containing images. © McGraw Hill LLC 20 10